Chicken bone marrow mesenchymal stem cells improve lung and distal organ injury

Mesenchymal stem cells (MSCs) are associated with pulmonary protection and longevity. We separated chicken bone marrow-derived mesenchymal stem cells (BM-MSCs); investigated whether BM-MSCs can improve lipopolysaccharide (LPS)-induced lung and distal organ injury; and explored the underlying mechanisms. Ninety-six male ICR (6 weeks old) mice were randomly divided into three groups: Sham, LPS, and LPS + MSC groups. The mice were intratracheally injected with 5 mg/kg LPS to induce acute lung injury (ALI). The histopathological severity of injury to the lung, liver, kidney, heart, and aortic tissues was detected. Wet/dry ratio, protein concentrations in bronchoalveolar lavage fluid (BALF), BALF cell counts, inflammatory cytokine levels in serum, inflammatory cytokine gene expression, and oxidative stress-related indicators were detected. In addition, a survival analysis was performed in sixty male ICR mice (6 weeks old, 18–20 g). This study used chicken BM-MSCs, which are easier to obtain and more convenient than other animal or human MSCs, and have MSC-associated properties, such as a colony forming ability, multilineage differentiation potential, and certain phenotypes. BM-MSCs administration significantly improved the survival rate, systemic inflammation, and the histopathological severity of lung, liver, kidney, and aortic injury during ALI. BM-MSCs administration reduced the levels of inflammatory factors in BALF, the infiltration of neutrophils, and oxidative stress injury in lung tissue. In addition, BM-MSCs administration reduced TRL4 and Mdy88 mRNA expression during ALI. Chicken BM-MSCs serve as a potential alternative resource for stem cell therapy and exert a prominent effect on LPS-induced ALI and extrapulmonary injury, in part through TRL4/Mdy88 signaling and inhibition of neutrophil inflammation and oxidative stress injury.


Methods
Isolation, culture, and cryopreservation of chicken BM-MSCs. Chicken bone marrow was obtained from 16-day-old chicken embryos. The connective tissues were carefully removed. Complete DMEM/F12 medium was utilized to flush the marrow cavity. Complete medium containing BM-MSCs was filtered through a 100-µm mesh sieve. After centrifugation, the cell pellets were resuspended in complete medium; seeded into 6-well plates (10 4 cells per well); and cultured at 37 °C. At 48 h post-seeding, the supernatant was discarded, the nonadherent cells and exfoliated tissue masses were removed. Thereafter, the medium was replaced every 24-48 h. 0.25% trypsin/EDTA was utilized to passage the BM-MSCs at a 1:2 dilution.
Cryopreservation of MSCs was essential for further research. When the BM-MSCs reached 90% confluence, they were digested and harvested in 15-mL sterile centrifuge tubes. The cell pellets were resuspended in freezing medium composed of 50% FBS, 40% DMEM/F12, and 10% DMSO. One milliliter of the resulting suspension (1 × 10 6 cells/mL) was stored at − 80 °C overnight, and then, the BM-MSCs were stored at liquid nitrogen tanks.
Flow cytometry. Using an established procedure, BM-MSCs in the logarithmic phase were dissociated into a single-cell suspension. After counting, 1 × 10 6 cells were transferred to a sterile centrifuge tube. Precooled 70% ethanol was added dropwise to fix the BM-MSCs, and then, the cells were gently prepared as a single-cell suspension, followed by incubation for 12 h. BM-MSCs were incubated with PBS containing rabbit-derived primary antibodies against CD73, CD90, CD105, OCT-4, SOX-2, CD34, and CD45. FITC-labeled goat anti-rabbit IgG was incubated with MSCs in the dark for 60 min. Finally, the MSCs were subjected to flow cytometry analysis.
Identification of the multilineage differentiation potential of chicken BM-MSCs. Detection of osteogenic differentiation. The complete medium was replaced with osteogenic differentiation medium when BM-MSCs reached 30% confluence. Half of osteogenic differentiation medium was replaced with fresh osteogenic differentiation medium every other day. On days 21 of culture and differentiation, calcium deposition was identified via Alizarin Red staining. All information on the induction medium is listed in Supplementary Material 1.
Detection of adipogenic differentiation. Third-generation BM-MSCs were inoculated in 6-well plates. The medium was replaced with adipogenic induction and differentiation medium when cells were 30% confluent. Adipogenic induction and differentiation medium was refreshed every other day for 21 days. Afterward, Oil Red O staining was used to detect the accumulation of intracellular lipid droplets.
Detection of chondrogenic differentiation. For chondrogenic differentiation, third-generation BM-MSCs were cultured in chondrogenic medium when they proliferated to 30% confluence. On day 21 of culture, Alcian blue staining was performed to confirm chondrogenic differentiation.
Detection of neuroblastic differentiation. When 30% confluence was achieved, BM-MSCs were exposed to neuroblastic differentiation medium. On day 21 of differentiation and culture, cellular morphology was detected.
Detection of the homing of BM-MSCs in lung tissue. To identify the homing of BM-MSCs in lung tissue, BM-MSCs were treated with CM-Dil (C7000, Life Technologies, Eugene, Oregon, USA) for 30 min in an incubator in the dark before BM-MSCs injection. Twenty-four mice were divided into three groups: (1) saline group (Sham), mice were intratracheally injected with a volume of normal saline equal to the volume of LPS; (2) LPS group (LPS), mice were intratracheally injected with 5 mg/kg LPS; and (3) LPS + MSCs group (LPS + MSC), mice were intratracheally injected with 5 mg/kg LPS. BM-MSCs were treated with CM-Dil for 30 min. An hour and a half later, 1 × 10 6 CM-Dil-labeled BM-MSCs was injected in caudal vein. Two weeks later, mice were sacrificed. Frozen lung tissue sections were examined to observe CM-Dil-labeled BM-MSCs via fluorescence microscopy.
Collection of BALF and tissue samples. We harvested blood samples of mice from the retro-orbital sinus. Blood samples were placed into blood collection vessels containing an anticoagulant. After centrifugation, the upper serum layer was frozen at − 20 °C. After sampling, the tissues were immediately transferred to liquid nitrogen tanks.
Two milliliters of ice-cold PBS was utilized to collect bronchoalveolar lavage fluid (BALF), the whole BALF was flushed three times, and the output fluid was harvested. The supernatant was immediately stored at − 20 °C.

Histopathology.
For the histological analysis, lung, liver, kidney, heart, and aortic tissue samples were dehydrated and embedded in paraffin. 5-μm-thick sections were stained with hematoxylin and eosin (HE) after administration of 5 mg/kg LPS for 6 h, 24 h, and 48 h. Following paraffin sectioning, 5-μm-thick sections were stained with Masson and Sirius Red after administration of 12 mg/kg LPS for 4 weeks. Images were captured with an inverted microscope and utilized to determine the degree of organ injury.
Detection of pulmonary permeability. The wet-dry weight (W/D) ratio of lung tissue and the protein content in the BALF were detected to quantify the degree of pulmonary permeability. Bibulous papers were utilized to absorb liquid and blood from the surface of the lung tissue, and then, the wet weight of lung tissue was determined. The lung tissue was dried until a stable dry weight was obtained. The W/D ratio was calculated according to the following formula: W/D = wet weight of the left lower lobe/dry weight of the left lower lobe. A Bio-Rad protein assay kit was utilized to calculate the protein concentration in the BALF. Evans blue (Sigma, St. Louis, MO, USA) extravasation from the lung tissue was detected with a spectrophotometer.
Determination of the oxidative stress index. MDA, SOD, MPO, and GSH levels in the mice were detected using spectrophotometry (Bio-Tek Instruments Inc., software KC4 v3.0), as previously described according to the manufacturer's instructions.

Measurement of extrapulmonary injury markers.
For histological analysis, liver, kidney, heart, and aortic tissue samples were fixed in 4% PFA for 24 h and embedded in paraffin. Following the paraffin sectioning method, 5-mm-thick sections were stained with hematoxylin and eosin (HE). Images were captured with an inverted microscope.
According to the manufacturer's specifications, the levels of markers of liver disease (ALT and AST) and kidney injury (urea and BUN) in serum were detected using commercial kits (Rsbio, Shanghai, China). Quantitative real-time PCR. Total RNA of lung tissues was extracted and used to synthesize cDNAs.
Relative gene expression levels were measure using real-time fluorescence quantitative PCR. We selected glycer- www.nature.com/scientificreports/ aldehyde-3-phosphate dehydrogenase (GAPDH) as the internal reference gene. Quantitative analysis was performed using the 2 −△△CT method. Supplementary Material 2 showed the murine PCR primer sequences.

Assessment of the survival rate.
For survival analyses, 60 mice were divided into the following groups: (1) saline group (Sham), in which the mice were intratracheally injected with the same volume of saline as the volume of LPS; (2) LPS group, in which the mice were intratracheally injected with 12 mg/kg LPS; and (3) LPS + MSCs group (LPS + MSC), in which the mice were intratracheally injected with 12 mg/kg LPS and then received 1 × 10 6 chicken BM-MSCs via a tail vein injection two hours later. ALL mice were intraperitoneally injected with the anti-rejection drug cyclosporine for one week before the experiment. The number of dead mice was recorded every 6 h for 48 h. Each group included 20 mice. Four weeks later, all the mice were sacrificed. All tissue samples were fixed, dehydrated, and embedded in paraffin. 5-μm sections of lung tissues were got, deparaffinized, and stained with Masson and Sirius Red.

Statistical analysis.
We performed one-way ANOVA and graphed the figures using GraphPad Prism 9 software. The significance threshold was set to P < 0.05. All data are expressed as the mean ± SD (x ± s). ) in lung tissue were detected. LPS administration prominently increased the expression of MDA (P < 0.05) and MPO (P < 0.05) and prominently decreased the expression of SOD (P < 0.05) and GSH (P < 0.05) compared to Sham. Significant increases in the MDA (P < 0.05) and MPO (P < 0.05) levels and significant decreases in SOD (P < 0.05) and GSH (P < 0.05) levels were detected after BM-MSCs administration compared to LPS.

BM-MSCs administration reduced lung injury.
Histological assessment showed evidence of inflammatory cell infiltration and interstitial edema. In the Sham group, there was no inflammatory cell infiltration and interstitial edema in lung tissue (Fig. 3A,D,G). The degree of lung injury, inflammatory infiltration, and interstitial edema increased after LPS administration ( Fig. 3B,E,H). Compared with the LPS group, treatment with BM-MSCs prominently decreased the degree of lung injury, inflammatory cell infiltration, and interstitial edema ( Fig. 3C,F,I). Thus, the histological analysis indicated that the administration of chicken BM-MSCs relieved the degree of lung injury at each time point.

BM-MSCs attenuated neutrophil content in lung tissue.
Micrographs were obtained to observe the density of neutrophils in the lung tissue. In the Sham group, there was no inflammatory cell infiltration in lung tissue (Fig. 4A). LPS injection prominently upregulated the density of neutrophils (black arrows) in lung tissue ( Fig. 4B), while BM-MSCs administration prevented this increase in neutrophil content (Fig. 4C). Similarly, LPS administration prominently downregulated neutrophil content (P < 0.01). BM-MSCs administration prominently upregulated neutrophil content in lung tissue compared to LPS ( Fig. 4D; P < 0.01). As shown in Table 1, LPS injection prominently upregulated neutrophil content (P < 0.01) and macrophage content (P < 0.01) in BALF. BM-MSCs treatment prominently prevented the increase in neutrophil content (P < 0.01) and macrophage content (P < 0.01) compared to LPS. While LPS or BM-MSCs had no effect on lymphocyte count (P > 0.05) and eosinophil count (P > 0.05).
Mason staining revealed the effects of BM-MSCs on pulmonary fibrosis. Compared with the Sham group (Fig. 7A,D), LPS injection prominently increased pulmonary fibrosis (Fig. 7B,E). While BM-MSCs treatment prominently inhibited the degree of pulmonary fibrosis (Fig. 7C,F) compared to LPS.
Sirius Red staining revealed the effects of BM-MSCs on pulmonary fibrosis in the airway wall. In the Sham group, there was no collagen fiber deposition in the airway wall (Fig. 8A,D). LPS injection resulted in increased collagen fiber deposition (Fig. 8B,E) compared to Sham. BM-MSCs administration resulted in decreased collagen fiber deposition compared to LPS (Fig. 8C,F).

BM-MSCs attenuated LPS-induced extrapulmonary injury. BM-MSCs attenuated aortic injury.
In the Sham group, the aorta was uniformly stained and arranged regularly, the endothelium was smooth and organized, and the elastic fibers had a regular, wavy shape (Fig. 9A,D). After LPS administration, the endothelium was not smooth or regular, the elastic fibers of the media became sparse, and the elastic fibers lost their regular, wavy shape (Fig. 9B,E). Compared with the LPS group, the shape of the endothelial elastic fibers and distribution of the elastic fibers were improved after BM-MSCs administration, but these fibers had not completely returned to their normal form (Fig. 9C,F).
As Table 3 shows, LPS administration increased the aortic intima media-thickness (P < 0.01) compared to Sham. BM-MSCs administration decreased the aortic intima media-thickness compared to LPS (P < 0.01).
BM-MSCs attenuated liver injury. The liver lobules of mice in the Sham group (Fig. 10A,D) were intact and clear, the cells were neatly arranged, the intercellular space was free of edema, the liver structure was clear and regular, and no symptoms of injury were observed. The liver lobules of mice in the LPS group were severely damaged, the liver cells were swollen, the intercellular space was absent, and a large amount of neutrophil (black arrow) infiltration was observed (Fig. 10B,E). The liver lobules of mice in the LPS + MSC group showed significantly less structural damage to the liver tissue, with clearer liver lobules and infiltration of a small number of neutrophils (Fig. 10C,F).
As shown in Table 3, LPS administration increased the expression of ALT (P < 0.01) and AST (P < 0.01), which were markers of liver disease compared to Sham. BM-MSCs administration decreased the expression of ALT (P < 0.05) and AST (P < 0.05) compared to LPS. www.nature.com/scientificreports/ BM-MSCs attenuated kidney injury. The kidney tissues from mice in the Sham group were intact and clear, the cells were neatly arranged, the intercellular substance was free of edema, cortical tubular epithelial cells were well shaped, and almost every epithelial cell contained intact nuclei (Fig. 11A,D). The kidneys of mice in the LPS group were severely damaged (Fig. 11B,E), the cells were swollen, and the intercellular space was absent, accompanied by neutrophil infiltration and hemocytes. In addition, septic mice had severe epithelial vacuolization (black arrows) and some nuclei disappeared (white arrows). Compared with the LPS group, septic mice had significantly less kidney tissue structural damage, clearer nephrons, and less vacuolization after BM-MSCs administration (Fig. 11C,F), suggesting that BM-MSCs administration reduced LPS-induced kidney injury. As shown in Table 3, compared with the Sham group, LPS administration increased levels of the kidney injury markers urea (P < 0.01) and BUN (P < 0.01), while urea (P < 0.05) and BUN (P < 0.05) levels were significantly decreased in the LPS + MSC group compared with those in the LPS group.
BM-MSCs attenuated heart injury. In the Sham group, the myocardial tissue was uniformly stained (Fig. 12A). In the LPS group, the myocardial tissue was disordered, myocardial degeneration and dissolution were observed, and a large number of inflammatory cells infiltrated the muscle space (Fig. 12B). The LPS + MSC group showed less inflammatory cell infiltration, and the myocardial fiber tissue structure was basically normal compared to the LPS group. The distribution of muscle fibers was improved but had not completely returned to its normal form (Fig. 12C).

Detection of BM-MSCs homing in lung tissue. To obtain data indicating whether BM-MSCs migrate
to the injured lungs, BM-MSCs were stained with CM-Dil, and the fluorescence signal was captured with a fluorescence microscope. DAPI staining was blue, and CM-Dil staining was green. Two weeks after LPS administra-

Discussion
Here, we performed preliminary studies to solve some pivotal questions, such as simple and effective methods for the separation and culture of BM-MSCs. Next, we characterized BM-MSCs by evaluating their colony-forming and multidirectional differentiation capabilities and the levels of specific surface markers. Finally, we explored whether BM-MSCs administration exerts a positive protective effect against LPS-induced ALI, and potential mechanisms, including inflammation and oxidative stress, were studied. Using bone marrow tissues obtained from 12-day-old chicken embryos, we separated and characterized a novel subset of MSCs, termed BM-MSCs, which showed unique mesenchymal stem cell-like properties. These plastic-adherent cells exhibited a spindle-like morphology similar to fibroblasts and possessed potent self-renewal www.nature.com/scientificreports/ potential. BM-MSCs derived from the embryonic mesoderm were induced to differentiate not only into cells that have an endoderm origin, such as adipocytes, osteoblasts, and chondrocytes but also into cells with an ectodermal origin, such as neuroblasts, confirming that BM-MSCs have cross-embryonic layer differentiation potential and further supporting their stem cell-like properties. The directional differentiation of the BM-MSCs was determined by the presence of different stimuli. LPS administration leads to an excessive inflammatory response, pulmonary edema, and infiltration of inflammatory cells, which are the three main features of ALI 23,24 . Treatment with BM-MSCs improved the LPS-induced excessive inflammatory response, pulmonary edema, and inflammatory cell infiltration. Based on these results, BM-MSCs are a potential treatment for LPS-induced ALI.
An excessive inflammatory response is a crucial component of the pathogenesis of ALI. We identified that deleterious accumulation of neutrophils in lung tissue is a crucial component of ALI development, which is consistent with previous experimental results 25 . In our study, deleterious accumulation of neutrophils in the lung, liver, kidney, and heart tissues was detected after LPS administration. BM-MSCs administration inhibited deleterious accumulation of neutrophils in organ. Our data showed that BM-MSCs administration alleviated LPS-induced liver, kidney, and heart injury via suppressing LPS-induced neutrophil infiltration. The underlying molecular mechanisms through which BM-MSCs reduced the neutrophil content were unclear. Previous studies have shown that TNF-α, IL-8, and CXCL-1 were chemotactic factors for neutrophils 26,27 . Strikingly, our data demonstrated that BM-MSCs treatment impaired LPS-induced CXCL-1, IL-8, and TNF-α release in lung Table 2. Cytokine levels in the BALF (pg/mL) at 6 h after LPS treatment. Our data revealed that LPS increased the levels of CXCL-1, IL-6, IL-8, IL-10, MMP-9, TNF-α, and TGF-β and decreasing the levels of IL-1RN in the BALF. Compared with the LPS group, BM-MSCs administration increased the levels of IL-10 and IL-1RN and decreased the levels of CXCL-1, IL-6, IL-8, MMP-9, TNF-α, and TGF-β in BALF. Values are expressed as the mean ± SD. # P < 0.05 versus the LPS group. **P < 0.01 versus the Sham group. ## P < 0.01 versus the LPS group.  www.nature.com/scientificreports/ tissue. Therefore, BM-MSCs treatment inhibited neutrophil infiltration by impairing LPS-induced CXCL-1, IL-8, and TNF-α release.
MSCs were used to treat many autoimmune and inflammatory diseases, including sepsis and ALI owing to their paracrine action, low immunogenicity, and immunomodulatory effects 28,29 . Paracrine immunomodulation was one of the key mechanisms by which MSCs provided tissue (i.e., heart, lung) protection, which was tightly regulated by critical signaling pathways, including the PI3K/Akt, RAP1/NFκB, and MARPK/ERK pathways [30][31][32] . Some researches indicated that mitochondrial donation in MSC transplantation can alleviate lung injury 33,34 .
Paracrine immunomodulation was closely associated with paracrine action of MSCs, including TLR4/Myd88/ NF-κB signaling 35 . Activation of TLR4/MyD88 signaling was a vital component in the development of ALI 36 . TLR4 was known as an important sensory receptor for LPS. The enhancement of TLR4 signaling pathway led to  www.nature.com/scientificreports/ the up-regulation of inflammatory response 37 . Disruption of the TLR4 inhibited lung inflammatory response, confirming the role of TLR receptor signaling in inflammation-associated diseases 38,39 . TLR4/NF-κB signaling pathway enhanced the expression of inflammatory cytokine including IL-1β and TNF-α, which resulted in the inflammatory response aggravation. Blocking the expression of TLR4/NF-κB signal resulted in decreased inflammatory response 40,41 . Our data demonstrated that LPS administration prominently upregulated TRL4, Mdy88, TNF-α, and IL-1β mRNA in lung tissue. GMSCs administration prominently downregulated TRL4, Mdy88, TNF-α, and IL-1β mRNA expression during ALI. Similarly, GMSCs administration prominently downregulated BALF levels of TNF-α, and IL-1β during ALI. Hence, GMSCs administration impaired LPS-induced TNF-α and IL-1β release via inhibiting TRL4/Mdy88 expression. In addition, neutrophil accumulation in the lung, which was a characteristic feature of ALI, was attenuated in TLR4 mutant mice, indicating the involvement of TLR4 signaling in neutrophil inflammation in the lung 42,43 . Excessive neutrophil inflammation was a crucial component of the pathogenesis of ALI. Our data found that LPS administration led to deleterious accumulation of neutrophils in the lung 44,45 . Deleterious accumulation of neutrophils in the lung was prominently reduced after BM-MSCs administration. Hence, GMSCs may reduce LPS-induced neutrophil infiltration in the lung via suppressing TLR4/Myd88 signaling. The oxidant/antioxidant balance was a vital component in the pathogenesis of ALI and that LPS administration led to oxidative stress injury 46 . In the present study, we found that BM-MSCs had an antioxidant effect. We demonstrated that BM-MSCs administration downregulated MDA and MPO expression but upregulated SOD and GSH expression in lung tissue. Hence, BM-MSCs alleviated ALI via modulating the oxidative/antioxidative balance. Table 3. The degree of organ injury. LPS injection increased the levels of the liver damage markers ALT and AST and the kidney damage markers Cre and BUN, which was improved by BM-MSCs administration. LPS administration increased the aortic intima media-thickness, which was reversed by BM-MSCs administration. Values are expressed as the mean ± SD. # P < 0.05 versus the LPS group. **P < 0.01 versus the Sham group. ## P < 0.01 versus the LPS group.   www.nature.com/scientificreports/ Previous studies have ignored the effects of LPS and MSCs on the aorta. Generally, vascular injury occurs before the onset of pulmonary edema and inflammatory cell infiltration. Inflammatory cells, including neutrophils, attack blood vessels first, and the vascular injury results in increased lung permeability, inflammatory cell infiltration, and pulmonary edema.
Here, the protective effects of BM-MSCs on the aorta in acute lung injury mice were first demonstrated. We found that BM-MSCs administration prominently prevented the increase in the total protein concentration and W/D ratio. Based on these results, BM-MSCs protected against LPS-induced vascular injury.
Mason and Sirius Red staining showed the effects of BM-MSCs on pulmonary fibrosis. LPS injection prominently upregulated BALF levels of the profibrotic factors MMP-9 and TGF-β, which was reversed by BM-MSCs administration. Similarly, LPS administration prominently upregulated the mRNA expression levels of the MMP-9 and TGF-β compared to Sham, while BM-MSCs administration prominently downregulated the mRNA expression levels of TGF-β and MMP-9 compared to the LPS group. This evidence showed that BM-MSCs administration alleviated pulmonary fibrosis via impairing LPS-induced TGF-β and MMP-9 release.
In contrast to traditional therapeutic methods, MSC-based therapy was a comprehensive intervention treatment. Previous studies have mainly focused on single factors and single pathways. The idea that one or two pathways exert a decisive role in ALI was not comprehensive and may explain why traditional methods for treating ALI are ineffective. However, MSC administration exerted a positive effect on ALI through multiple mechanisms simultaneously, including inhibition of an excessive inflammatory response and oxidative stress injury. In addition, BM-MSCs administration decreased vascular injury and lung edema. All of these factors combined improved the survival rate of ALI mice. Overall, chicken BM-MSCs serve as a potential alternative resource for stem cell therapy and exert a prominent effect on organ injury including lung, liver, kidney, heart, and aortic injury. BM-MSCs administration increased the antioxidant and anti-inflammatory capacities during ALI.  www.nature.com/scientificreports/ BM-MSCs reduced the excessive and uncontrolled inflammatory response involving inflammatory mediators and effector cells, among which neutrophils play a key role. BM-MSCs reduced the neutrophil content, in part because BM-MSCs inhibited the expression of CXCL-1, IL-8, and TNF-α. BM-MSCs altered the levels of inflammatory mediators, partially through inhibition of TLR4/Myd88 signaling.
Previous work demonstrated that different tissue origin-derived MSC displayed different expression levels of human leukocyte antigen (HLA) responsive to inflammatory stimuli [47][48][49][50][51] . Some studies suggested that MSCs had low immunogenicity, while other studies showed that MSCs were not immunogenic. We suggested that MSCs exhibited low immunogenicity. Hence mice were intraperitoneally injected with the anti-rejection drug cyclosporine for one week before the experiment. Compared with bone marrow-and adipose-derived MSC, GMSCs may display different expression levels of HLA responsive to inflammatory stimuli. Our data did not detect the expression levels of HLA responsive to LPS administration.
Limitations. Some limitations of our research should not be ignored. Our data demonstrated that BM-MSCs have multidirectional differentiation capabilities. However, the mechanisms underlying the differentiation of BM-MSCs are unclear. Hence, further research into the inducers and differentiation mechanisms is desperately needed, and these studies will be quite important for cell-based treatment and regenerative medicine. MSCs play a prominent role in both restoration of ALI and in protecting vascular injury and restoring endothelial barrier function. Generally, vascular injury occurs before the onset of pulmonary edema and inflammatory infiltration. Our data demonstrated that BM-MSCs protected against aortic injury. However, the underlying molecular mechanisms involved in the preventive effect of MSCs in ALI-associated aortic injury have not yet been fully elucidated. Our data ignored the effects of BM-MSCs on the change in lung function index and pulmonary hypertension.